Identification of malnutrition in infants using ultrasound – a proof-ofconcept
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Date
2022-09-01
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Kamuzu University of Health Sciences
Abstract
Study Type: Cross-sectional case-control:
The problem: Early identification of at-risk infants for severe malnutrition (SM) has been
highlighted as a top research priority. However, few easy and reliable diagnostics are available
and predictive for infants and children. Current anthropometric measures (such as weight-forlength/
height z scores, WLZ), have <50% sensitivity for predicting mortality, and poor
correlation with mid-upper arm circumference (MUAC). Other, more sensitive measures of
growth and nutritional status may be body composition (fat mass and fat-free mass), thymus
gland, and other organs, however current approaches are time- and labour-intensive and require
specialized equipment such as CT, MRI or air displacement plethysmography.
A noninvasive test that can measure correlates of nutrition and be done at the bedside, such as a
ultrasound, may, if shown to be sensitive and a good predictor of morbidity and mortality,
support screening for therapeutic feeding programmes in low resource settings.
Broad objective: To assess utility of ultrasound in identification of malnutrition.
Specific objectives:
1. To document feasibility of conducting ultrasound measurements in infants.
2. To determine inter-user reliability and reproducibility in ultrasound measurements.
3. To evaluate whether there are differences in measurements between malnourished v. nonmalnourished
infants. Place of study: Queen Elizabeth Central Hospital, Paediatric wards.
Study population: Children <6 months of age.
Study methods:
• 10 infants <6 months hospitalized with malnutrition will be age- and sex-matched with
10 non-malnourished hospitalized children.
• For each enrolled infant, sociodemographic data (clinical diagnosis, birthweight),
anthropometry (weight, length, MUAC) and ultrasound measurements (biceps,
quadriceps, rectus abdominis, thymus, etc) will be collected, measured and documented.
Expected findings and their dissemination: We expect that ultrasound measurements in infants
will be feasible, and have reasonable inter-user reliability and reproducibility between
examiners. We expect to identify differences in measurements between infants with and without
malnutrition. Study findings will be presented to MLW, QECH, and COMREC Research
Dissemination Conference, and may be published in a peer-reviewed journal.
Description
Cross-sectional case-control